Active NPI
Kelly Gillin, CCC-SLP
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1154582872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA5440
- Practice address
- 2408 Delaney Ave
Orlando, FL 32806-4524 - Phone
- (407) 247-7305
- NPI assigned
- Jun 25, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA5440 | FL | Primary |
Addresses
Primary practice location
2408 Delaney Ave
Orlando, FL 32806-4524
Mailing address
2408 Delaney Ave
Orlando, FL 32806-4524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 889600300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA5440 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1154582872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 DELANEY AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328064524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 DELANEY AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328064524",
"telephone_number": "407-247-7305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIN",
"first_name": "KELLY",
"name_prefix": "Ms.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA5440",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "889600300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.